title: An autopsy case of unexpected sudden death due to rupture of a thoracic aortic aneurysm into the left lung.
abstract: Ruptured aortic aneurysms present with various signs and symptoms depending on the site of rupture and bleeding, often causing sudden death; however, rupture into the lung with hemoptysis and blood aspiration is very rare. We report a case of unexpected sudden death due to blood aspiration from rupture of a thoracic aortic aneurysm into the lung. An 83 year old man, who had a past history of surgery for an abdominal aortic aneurysm about 17 years previously, was found dead on his bed with massive hemoptysis. Medico-legal autopsy revealed rupture of a thoracic aortic aneurysm into the left lung, causing massive blood aspiration. Tight, diffuse pleural adhesion and the vulnerable wall of an aortic aneurysm due to advanced atherosclerosis with active inflammation appeared to have predominantly contributed to the penetration of the ruptured aneurysm into the lung. This case suggests that long-term clinical follow-up and management are needed for a patient with aortic aneurysm, and that a ruptured aortic aneurysm should be taken into consideration to identify the source of bleeding for hemoptysis.
authors.affiliation: Department of Legal Medicine, Osaka City University Medical School, Japan.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Chen
authors.forename: Takaki
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Tomomi
authors.initials: T
authors.lastname: Michiue
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Maeda
mesh_terms: D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000150:complications / Q000473:pathology*; D017545:Aortic Aneurysm, Thoracic / Q000473:pathology*; D050197:Atherosclerosis / Q000473:pathology; D003645:Death, Sudden / Q000209:etiology*; D049429:Forensic Pathology; D006469:Hemoptysis / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008297:Male; D053120:Respiratory Aspiration / Q000209:etiology / Q000473:pathology*; D000267:Tissue Adhesions / Q000473:pathology